Not Okay
by ElizabethWriter
Summary: Dr. Tom Kent unexpectedly gains a new patient when a teenage girl suddenly has a fit. What happened to her?
1. Chapter 1

**AN: Hey, long time no read! I rewrote the first chapter, so here it is! Hopefully I'll have the second for you soon. Don't forget to review!**

Dr. Tom Kent was coming to the midpoint of his day at the hospital as a pediatric emergency physician in the ED. It was a relatively slow morning in the department, and he was ready to grab a bite to eat at the cafeteria. Wearing his surprisingly flattering pale green scrubs with a pager on his waist, he left the department in the hands of the [hypothetically] competent F2s.

He pushed open a pair of doors and saw a teenage girl, looking very poorly, at the end of the hallway. Perhaps she was trying to get to the ED. It certainly didn't look like she was going to make it there without help and he began to approach her. He was looking over her body for obvious injuries as he neared, but suddenly the girl weakened. He picked up his pace, quickly arriving at her side to steady her.

"Are you alright?" He asked, placing a supportive hand under her forearm.

The girl immediately flinched and pulled her arm away like he had hurt her. Tom was not certain who this young lady was, but she was definitely in some sort of distress.

"Uh, yes. Yes I am," she said with little confidence.

"Are you sure…" Tom replied as he overstatedly squinted at her nametag, seeing that it read: Ruby Isies, Volunteer. He realized that she wasn't there for medical attention—but she definitely should receive some.

"Ruby? I can take a look at you if you…"

"No," Ruby interrupted, suddenly embarrassed by the episode, "No, I'm fine, really." She smiled softly, and she began to proceed down the hallway while Tom hesitantly nodded, watching her go.

Ruby asked herself what had just happened. She considered that maybe she just hadn't eaten enough or was a bit dehydrated. Before she could finish mentally comforting herself, the episode reoccurred even more aggressively.

She let out a cry as pain cracked like thunder in her head.

She could barely see anything in front of her and she lost her hearing in one ear, then the other. She felt disoriented and stiff, stumbling into the wall before losing her awareness all together.

Tom had just turned to walk away when he heard her cry. He swung around quickly to see his newest acquaintance become his newest patient as she began to fall to the ground. He leapt towards her while falling to his knees trying to slide his arms underneath her. He hoped to soften the impact of her body and the floor and once there, he shifted himself to kneel at her side.

"Can you hear me? Ruby?" He stated firmly. She gave no response and he became very concerned with her sudden diminishing condition. Ruby's stiff body began to jerk violently as she clearly began to have a fit. Tom held her head to prevent her from hitting it on the ground.

"Hey! I need some help over here!" He called out.

He flipped her nametag over, looking for any medical history information. All of the employees and volunteers had their health conditions listed on the back of their cards in tiny print in case of emergency. He found just one condition listed, asthma, which did not account for her current state in the slightest.

Even more concerned by the mysteriousness of her sudden illness, he called out again:

"Someone get a trolley out here now!" He left one hand under her head and used the other to take out his penlight and checked both of her pupils, one of which was much larger than the other. Why Ruby was still deteriorating was unclear to Tom. He looked around for more clues noticed some fresh bruises on her arms and legs.

A group of three nurses appeared with a gurney at the end of the hallway and rushed over to help. "This is Ruby, volunteer, found seizing in the hallway. No history of epilepsy. We're about one minute in," he reported. "We're not going to be able to get her up on the trolley like this- go grab some Lorazepam."

One nurse sprang up and started to jog back to the nearest ward. He directed to another nurse, "Go to the volunteer office and pull the medical forms on Ruby Isies. Meet us in the ED—tell them we're coming."

Just after the nurse left, the first returned with a syringe and a small glass bottle.

"How much?" she asked.

"Lets try five mgs," he said as the nurse drew back the plunger and handed it off to Tom, who quickly delivered the injection into Ruby's shoulder.

Slowly, Ruby's movements became less intense. She became looser and her once violent jerks were now limited to twitching motions. Her breathing began to slow, but was cut off by a gurgling noise that soon progressed into a gag.

"She's vomiting," Tom said as he and another nurse grasped Ruby's opposite arm to roll her onto her side. Now off of her back, the fluid cleared from her mouth and they could return her to her original position.

Ruby's breathing resumed and Tom unlaced the stethoscope from around his neck and listened to each section of her chest. There were no sounds of respiratory trouble and he then checked her pulse, which was fast but adequate. Ruby was almost still and her eyes remained open. One nurse tried to rouse her, rubbing her chest and calling her name.

Ruby did not respond and Tom said, "Yeah, she's still post-ictal. Let's see if we can move her now." With a nurse on each side and Tom stabilizing her head and neck, they successfully lifted Ruby onto the gurney. Tom had a nurse take hold of Ruby's head and again took out his penlight, moving the light over her left eye. He shifted the bright beam to her right eye and Ruby weakly tried to withdraw her head, closing her eyes. Tom was happy to see her consciousness level rising.

"Hey Ruby, can you hear me?" he asked with newfound enthusiasm.

Ruby looked up at him a bit dazed, trying to focus her overwhelmed eyes. She wanted to speak, but she couldn't seem to produce words. She released a sound resembling "Yes." She began to register that the walls around her belonged to the hospital. She then remembered coming to the hospital that morning, but had no idea how she ended up lying on a bed in a hallway. One of the faces overlooking her spoke:

"Hi Ruby, I'm Dr. Kent. You had a fit just now, has that ever happened to you before?" She microscopically shook her head, realizing that it was being firmly held in place by the nurse above her. Tom motioned to the nurses and they all began to move Ruby towards the elevator.

Listening to the dings of passing floors, Ruby remained puzzled to hear she had suffered a fit. Tom was relaying some medical jargon to one of the nurses when the doors slid open with a final ringing of the bell. Zoe and Tess greeted them.

Tom gave the summary of Ruby's condition once again.

"This is Ruby, volunteer, found in new onset tonic-clonic seizure, lasted four minutes, vomited once, five of lorazepam on board," he briefed. They arrived next to another bed and Ruby still felt incredibly tired. "Lift on three- one, two, three," he said, and on his command Ruby was lifted from one bed to the other.

They began to hook up all sorts of machines to Ruby, clipping one to her finger, pressing several onto her chest, all while people listened to her lungs, strapped a brace around her neck, pressed her abdomen and stuck her with an IV needle. Each nurse and doctor alerted the drowsy Ruby before doing anything, but it was just one big jumble of information. "Little pinch here," or "I just need to take a listen," and "tell me if any of this hurts," all mixed together in her head.

She was incredibly uncomfortable with everyone around her, touching her. The doctors exchanged knowing glances as their examination revealed more bruising.

Finally, Tom directly addressed her: "Ruby, can you tell me what year it is?" She thought for a moment.

"Two thousand… and…" she trailed off, looking up at Tom as she gave up.

"Ok," he nodded, taking note of her disorientation. He was suspicious of her unstable vitals on the monitor.

An oxygen mask was slid over her mouth. She immediately felt suffocated and claustrophobic, launching herself into a panic. Ruby let out a small cry and rustled on the gurney intently, moving her arms frantically. Tom instantly reached down to grasp and quiet her frightened hands.

"Whoa, ok, you're ok," he soothed, keeping one hand in hers and using the other to remove the mask. He comforted her before applying a nasal cannula. Ruby started to become more heavy-eyed.

Tom thought of a new possible cause of Ruby's fit. "Ruby, have you hurt your head at all recently?"

She took a moment and then nodded her head slowly.

"Can you tell me what happened?" Tom asked.

She shook her head as much as she could with it secured in the neck brace, feeling another wave of panic pour through her. Her respirations increased and tears filled her eyes. Tom shared a concerned look with Tess.

Zoe started to examine Ruby's arm, but Ruby pulled away with yelp.

"Please, stop hurting me!" she cried sadly between labored breaths. Tom gently placed a hand on her shoulder.

"Ok, it's ok, we're going to take good care of you, alright?" he said.

Ruby looked up at him with eyes full of fear, and he met her gaze with reassurance and comfort.

**AN: What's wrong with Ruby? What is she hiding? Will Tom be able to help her? Please leave a review**


	2. Chapter 2

**A/N Tom tries to piece together what has happened to Ruby. Will he get answers? Read to find out!**

"Can I get some morphine please?" Tom directed to a nearby nurse. "I'd like to order a head CT and a rapid scan as well."

Ruby looked up at him with question. The much-needed morphine was injected into her IV.

"I think when you hit your head earlier, it may have damaged a vessel in your brain," he said, keeping a light tone in his voice to keep her calm, "I'm going to get you a scan to see if there's any bleeding."

"Okay," Ruby replied quietly.

"I'm also getting a scan of your body to see you haven't injured anything else," Tom added.

Ruby's breathing became faster and her jaw tensed, her eyes filling with tears.

Everyone took note of her clear anxiety. Ruby seemed more afraid of having a body scan than having a bleed in her brain. Tom knew something was wrong here, along with Tess.

"Ruby," he raised his chin and gently spoke, "We want to help you okay?"

Ruby gave a hesitant nod.

"We're going to bring you to radiology now to get those scans, alright?" Tess chimed in.

Ruby nodded again, still filled with uncertainty. Tom watched as they rolled her away and into the elevator.

"Could you find next of kin?" Tom relayed to a remaining nurse. She nodded and returned to her station.

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Tom was working on Ruby's chart at the nurse's station when he heard a distant ruckus. He looked up to see Tess and a couple of porters bursting through the doors with a trolley.

"Dr. Kent!" She loudly called out.

Tom straightened up, immediately threw down the paperwork and recognized his patient. It was Ruby, writhing in pain with her cries muffled by an oxygen mask.

"Bed one," he simply directed, running toward the doors of the trauma area. He met Tess at the side of the trolley as they rolled into resus.

"What happened?" Tom asked quickly, looking down at Ruby who was grabbing at her head.

"We were on our way back from radiology. We were in the elevator when this started," Tess reported.

"Okay," he replied. He turned his focus back to his patient. "Ruby?" Tom called urgently.

Ruby's eyes opened at the sound of his voice and then screwed them shut. Her only response was another cry. Monitors began to beep erratically.

"She's hypertensive," Tess announced. Ruby was becoming less responsive.

"Ruby?" Tom called again, trying to keep her attention, but her eyes faded away.

She began to seize once again. "I need 10 milligrams of lorazepam!" He shouted.

The team made sure that Ruby stayed safe, preventing her from hitting the sides of the trolley. Tom drew up the lorazepam and delivered the injection into Ruby's IV. She began to still.

"Can you hang 100 grams of mannitol please?" Tom directed to one of the nurses.

The nurse nodded and went off to the stock room.

"Okay," Tom breathed conclusively, "Her BP has come down. The mannitol will prevent more seizures." Tom began to update her chart. A few minutes later, Tess approached him.

"Her scans are in," Tess told him, handing him a tablet. They looked over it together.

Tom scrolled through the head CT and stopped, pointing: "Yep, there it is, a small bleed in the left temporal lobe. That's probably small enough to control with the mannitol."

"And her full body scan," Tess swiped over to a new screen. They both gazed at the picture, Tom zooming in on various parts of the scan. She looked at him as his face became etched with dismay. Ruby's body had multiple fractures in various stages of healing.

"She's been abused," Tom sighed.

"Explains the combativeness, not wanting to be touched…" Tess listed off. Tom nodded somberly in agreement.

"When she comes around enough, I'll have a chat," Tom responded.

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Some time had passed and Tom decided to check on Ruby with Tess. He took her chart and pulled back the curtain. He was surprised to see a man, sitting in the chair next to her bed.

"Hello, I'm Doctor Kent, this is charge nurse Tess" He said, extending his hand. The man took it firmly.

"I'm Steven. Ruby's dad."

Tom gave him a small nod and then looked over at Ruby. She looked a bit pale, but seemed to be holding her own.

"What's happened? How is she?" Steven asked.

"Right. Ruby suffered two fits. We did a head CT and it showed a small bleed in her brain, which was the cause of her seizures. The medications we have started will keep the swelling in her brain down, and the bleed is small enough that it will resolve on its own."

"Oh good, so she can go home soon?" Steven replied.

"Not exactly," Tom shook his head, "She needs to stay under observation and continue her medication." Tom paused, wanting to carefully word his question. "I am also concerned about how this bleed began. Based on her presentation and bruising on the scalp, it appears that head trauma has caused this. Have you had any accidents lately, Ruby?"

Ruby looked at Tom and over to her father. "Oh, well, I actually took a tumble riding my bike on the way here," She reported slowly.

"Quite a clumsy girl, aren't you?" Steven added quickly with an artificial smile.

"These episodes of clumsiness—do they happen often?" Tom inquired

"Yes," Ruby replied quickly, "All the time," she laughed gently.

"Do you remember what you were doing before you fell off your bike? Were you feeling dizzy or…" Tom trailed off.

"Oh, yeah," She said exclaimed, suddenly and unnaturally, "I must've forgotten breakfast."

"I keep telling her not to skip meals. Always on the go, this one," Steven chuckled, gently grasping at her shoulder. Ruby faintly flinched at his touch, then quickly forced a smile.

"Alright then. I'll see if your blood tests have come back, and then I will have some more information for you." Tom replied. They exchanged a nod and Tom left the cubicle with Tess. As soon as they were out of earshot, Tess spoke up.

"She's afraid of him," She said. Tom sighed.

"Let's try to get dad out of the picture. See if we can talk to Ruby alone."

Tess went back to the cubicle and asked Steven to come out to do some paper work, luring him over to the nurse's station. Tom took his chance and returned to the cubicle. Hopefully he could get her talk.

**A/N: Will Ruby be able to tell Tom what is happening? Does she even remember? Are Tom and Tess on the right track, or is there more than meets the eye? Review and share what you think!**


	3. Chapter 3

**A/N: Let's see what Tom uncovers. Read and review!**

The whirring of the curtain being opened startled Ruby, causing her to jump. She swiftly tried to cover it up by shifting under the sheets. Tom approached her bedside.

"Ruby," he started, "I'm worried about what I'm seeing on your scans. It looks like you've gotten hurt quite a few times."

"I told you," she breathed with a relaxed smile, "I'm just a little clumsy."

"The thing is, Ruby, the way you're fractures have healed suggests that they occurred in an unusual way," Tom explained.

"What do you mean?" Ruby interjected quickly.

"A lot of the scar tissue is diagonally angled," Tom said slowly, "in areas that can be grabbed and twisted."

"Oh," she replied with a light laugh, "Leave it to me to be injured in wonky ways!" A smile flickered across her face and faded quickly into bags beneath her eyes. Her cheeks twitched as if holding back tears.

Tom sighed and gently sat on the foot of her bed, not buying into her cover up at all. He leaned in a bit.

"Ruby," he nearly whispered, "If something bad is happening—if someone is hurting you—we can help."

"No—no one is hurting me," she stated incredulously with an offended expression. She was clearly holding back an ocean of tears, refusing to look him in the eye. "I already told you. I'm just a klutz."

Tom didn't want her to shut down.

"Maybe I don't understand what happened to you, Ruby. But I know you're scared," He said gently. Ruby had no response to this. She just continued to look away. "If you are in danger, we can protect you."

Ruby looked up at him. The curtain suddenly flung open and Steven stood in the entranceway.

"What's going on here?" Steven asked with just a hint of a passive aggressive laugh. He looked at Tom and then to Ruby. Tom hopped off of the bed.

"Just checking in to make sure we have your daughter's pain under control," Tom smiled confidently.

"Okay," Steven flung a half smile back and made his way back to the chair beside Ruby.

Tom began to exit, then turned back to close the drape. He caught Ruby's eye contact for a moment and gave her a supportive look. She stared blankly back, as Steven took her hand.

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Tom had received word that a bed in the neuro unit was available for Ruby. He stood at a computer, completing a chart. Tess approached him.

"Tom," Tess called his attention.

"Yes," Tom replied, looking up.

"I found this, in Ruby's pocket," She replied, handing him a small card.

It was a bus pass, dated from earlier that morning.

"I don't think Ruby even rode her bike here," she explained.

Tom looked to Ruby's cubicle and sighed. He nodded in understanding.

"Thanks Tess," He said. Caught in yet another lie, he wondered how to gain Ruby's trust. It was time to check in on her again to let her know about the ward upstairs anyway.

As Tom entered the cubicle, Steven was rustling about, handing Ruby her clear bag of clothes while gathering their things.

"Mr. Isies," Tom stated with surprise, realizing that he was preparing to leave.

"Sorry, we've got to go," Steven simply replied.

"It would be incredibly dangerous for Ruby to leave right now," Tom replied, shocked to see this man seemingly oblivious to the gravity of Ruby's illness.

Steven stood in front of the bed, completely separating Ruby from the conversation. "I talked to her GP and we will have a private set up at home for her,"

"I highly advise against that," Tom replied firmly, "She needs close observation here in hospital." Tom looked over to Ruby who was staring blankly down at the bed sheets.

"Really, we have it completely under control with _our_ doctor," he reassured, before looking back at Ruby, "and you're already feeling much better now, aren't you darling?"

The slight force in Steven's tone furthered Tom's distrust in him. Ruby moved only her eyes to look at her father and weakly smiled at him with a nod.

"Sir, we've got a bed on the neurology unit for your daughter. At least let them evaluate her." Tom appealed with clear frustration.

"She'll be much more comfortable at home," Steven countered, "Isn't that right, Ruby?" Steven did not even look to Ruby for a response.

Tom immediately eyed Ruby, trying to find any sort of response. She seemed numb, unaltered.

"Do you think you're feeling well enough?" Tom asked her directly, looking past Steven, as if he weren't there.

Ruby looked to Steven silently. Steven looked back over his shoulder and immediately jumped in.

"She's never been one for hospitals, I'm afraid," Steven chuckled quietly.

Tom was fed up.

"I'm sorry, but I can't allow you to leave," Tom said bluntly with no compromise in his voice.

"You can't possibly keep us here," Steven sneered, "This is my daughter and this is what's best. Now if you'll excuse me."

Tom stood in disbelief as Steven turned around, crouching to collect his belongings.

Ruby straightened subtly, catching Tom's attention. She locked her eyes onto his; her eyes were wide and full of wild fear. Her expression tensed with panic as she looked at him. She silently and rapidly shook her head, tears welling in her eyes.

Tom's face dropped, realizing the Ruby was finally signaling for help. He shifted, thinking of something he could say to Steven before he turned back around, but he was interrupted.

Ruby began to scream. This was a perfect distraction. Tom couldn't be completely sure if Ruby had fabricated the distraction, or if the stress of the situation had truly triggered another episode. Regardless, he jumped into action, immediately arriving at Ruby's side.

"I need help in here, please!" he turned, shouting out towards the ward.

"What's happening?" Steven demanded.

"Ruby, you're okay," Tom reassured her, taking out his penlight. He ignored Steven.

Zoe, Tess and a multitude of other nurses hurried into the room. The head of the trolley was laid flat. Ruby kept her eyes tightly shut, continuing to yelp.

"Hey, I need you to look at me Ruby," Tom said slowly. Ruby forced her eyes open as he passed the beam of light over them.

"Tell me! What's happening?" Steven yelled again.

The nurses essentially disregarded Steven as well. They began to move around Steven, quickly bumping him outside. A nurse stated they needed room to work and escorted him to the waiting area.

Ruby's pupils were normal and her vitals had hardly strayed from average. Tom knew that she was probably feigning this episode. He spoke quietly into Ruby's ear. "Your dad's gone," he said, "You're okay, Ruby."

Her cries slowed, but they were replaced by sobs. She rolled onto her side and curled herself into a ball. The nurses stood, slightly confused as to why her condition had changed.

"Gives us a moment," He softly directed the nurses. The cubicle cleared out, leaving just Tom and Ruby, as Tess stood off in the corner. Tom pulled a chair up to Ruby's bedside, though she did not look at him. He spoke to her so gently.

"Ruby," He said quietly, "We found a bus pass from this morning in your wallet. Did you really ride your bike to the hospital today?" He asked quietly.

Ruby shook her head, still not looking at Tom.

"Can you tell me what really happened?" Tom asked.

**A/N: Are you ready for Ruby's full story? What will it be? Can Tom help her, or will Ruby be hurt once again? Review if you would like to predict!**


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